| NPI | 1912343906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA A QUINN Owner 904-595-5980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: FL ME94947) |
| Additional Taxonomies | 133VN1006X Dietitian, Registered, Nutrition, Metabolic (Licence: FL ME94947) |
| Enumeration Date | 2013-05-16 |
| Last Update Date | 2013-10-31 |